Stress and Addiction

Stress is the brain’s response to stimuli and demands, the National Institute on Mental Health (NIMH) reports, and it can be either good or bad. When a person feels stressed, brain chemistry responds and some of the chemical messengers are impacted. Adrenaline levels spike, causing an increase in norepinephrine and epinephrine, for example. Focus becomes honed and functions of the central nervous system, like body temperature, blood pressure, respiration rates, and heart rate, are increased. Cortisol – often referred to as the “stress hormone” – levels are heightened in periods of stress.

Stress can be helpful in some situations, increasing muscle tension and oxygen to the brain and leading to heightened energy and excitement levels. It is when stress becomes chronic, or reoccurring, that a problem may exist. Routine stress, or stress from a traumatic event or sudden negative occurrence may cause unhealthy levels of stress and the stress response. High levels of cortisol in the brain on a regular basis can actually damage its function as white matter and the hippocampus may actually shrink with chronic stress, Psychology Today publishes. The hippocampus is part of the brain that helps a person to successfully manage emotions, and it is also involved in memory functions. Perpetuated stress, and elevated levels of cortisol, may make someone more vulnerable to mental illness, the journal Molecular Psychiatry warns.

Hormones and brain chemistry negatively impacted by chronic stress may lead to a variety of health concerns, including:

Digestive problems

Difficulties sleeping

Muscle tension and pain

Trouble regulating body temperature

High blood pressure and irregular heart rate

Heightened risk for diabetes, heart disease, and chronic hypertension

Reproductive issues

Changes in energy levels

Disruption of concentration, focus, and other cognitive issues

Lowered immune system, leading to infections, viruses, or other health concerns

Headaches

Mood swings as well as increased anger, irritability, depression, and anxiety

Many substances of abuse also impact brain chemistry and may seem to temporarily relieve stress. Alcohol and benzodiazepine drugs, including drugs like Xanax (alprazolam), Valium (diazepam), and Ativan (lorazepam), serve to lower the central nervous system (CNS) response to stress. Heart rate, blood pressure, respiration rates, and body temperature are all lowered as levels of the brain’s natural tranquilizer gamma-aminobutyric acid (GABA) are increased. Opioid drugs, which include both heroin and prescription painkillers, also serve as sedatives, decreasing CNS functions and lowering stress levels artificially and temporarily. Other drugs may alter perceptions and reality, like marijuana or hallucinogenic drugs, for instance, thereby also temporarily decreasing the stress response.

These may be a desirable effects for someone experiencing stress as these substances may, at least in the moment, seem to alleviate some of the negative stress response and provide a kind of “escape” for the time being. Inevitably, however, the drugs or alcohol will wear off, and individuals may be worse off than they were before. Substance abuse can actually make stress worse and lead to more negative consequences and side effects.

Strong Correlations between Substance Abuse, Addiction, and Stress

Stress can impact a person’s propensity to abuse substances and make changes to the brain that make it difficult to stop using them, both worsening stress and potentially leading to substance dependence and addiction. Both chronic stress and regular substance abuse may negatively disrupt similar regions of the brain.
Drugs and/or alcohol may be a coping mechanism for stress initially and lead to impaired impulse control functions, emotional regulation, and executive learning functions, increasing the risk for addiction, the journal Annals of the New York Academy of Sciences publishes. Drugs and alcohol increase levels of dopamine, thus heightening feelings of pleasure, while temporarily blunting many negative thoughts and memories. Over time, levels of dopamine are negatively affected and the brain stops making it at necessary levels. Depression, anxiety, and difficulties feeling pleasure are common side effects of this altered brain chemistry. Individuals may experience drug cravings and intense withdrawal symptoms without the substance, therefore making it difficult to stop taking it.

In addition, stress levels may therefore actually be increased with regular substance abuse. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) reports that the body and brain’s stress response can rapidly move a person through the stages of substance abuse and into addiction.

Some people may be more vulnerable to high levels of stress due to brain chemistry and makeup, and these same regions may predispose them to drug or alcohol dependence and addiction as well. Age can also play a role. For example, the prefrontal cortex is not fully developed in children and teenagers, meaning that they may not be able to control their impulses as well as adults, leading to risky behaviors or poor decisions. Almost three-quarters of teens who use drugs do so to relieve stress, according to 2008 study published by the Partnership for a Drug-Free America. When high levels of chronic stress, or a traumatic event causing stress, are present at a young age, these parts of the brain may be negatively impacted.

The journal Depression and Anxiety reports on surveys of adolescents being treated for substance abuse issues and found that approximately 70 percent of them also reported exposure to trauma. Similarly, individuals who abused alcohol or marijuana before the age of 15 were found to be more likely to suffer from substance dependence as adults than those who waited to try it until after age 18, according to the 2013 National Survey on Drug Use and Health (NSDUH). Substance abuse can also increase the risk for being the victim of a traumatic event. Between 45 and 66 percent of adolescents studied who battled substance use disorders were exposed to trauma after developing problems with drugs or alcohol, The National Child Traumatic Stress Network (NCTSN) publishes.

High levels of stress at a young age, and childhood trauma, like neglect, abandonment, or abuse, can increase the odds of turning to drug or alcohol as a method of coping tool, which in turn can lead to drug dependence and addiction.

PTSD and Substance Abuse

PTSD is a stress disorder wherein individuals are in a constant state of hyperarousal after exposure to a significant or life-threatening trauma. The “fight-or-flight” reaction to a stressful situation cannot be turned off. Difficulties sleeping, re-experiences of the event, avoidance of anything associated with the event, irritability, anxiety, anger, feelings of being on edge, inability to remember the event, negative perception of self, and loss of enjoyment in the world are common symptoms of PTSD.

Affecting twice as many women as men, Psych Central publishes that American adults have almost an 8 percent lifetime prevalence of PTSD. Alcohol and drugs are common tools for the self-medication of PTSD, and nearly 35 percent of men and 27 percent of women battling PTSD also suffer from drug dependence or abuse, according to the National Institute on Drug Abuse (NIDA). PTSD is particularly common in the veteran population and in veterans who suffer from PTSD, 20 percent also battle an SUD, the US Department of Veterans Affairs (VA) reports.

Co-occurring substance abuse can interfere with treatment and recovery for PTSD and heighten the symptoms individuals may be trying to suppress via drugs or alcohol.

Detox and Beyond

Stress and substance abuse exacerbate and complicate each other, leading to high relapse rates, difficulties regulating emotions, and trouble controlling negative impulses. Addiction is a complex brain disease that affects around one out of every 12 adults in the United States, according to the 2014 NSDUH. Addiction involves an inability to stop using drugs and/or alcohol, increased risk-taking behaviors and poor decisions; a near obsession with using, obtaining, and recovering from substance use to the exclusion of most everything and everyone else; a decline in physical health; mood swings; relationship issues; financial strain; and even a potential shift in personality altogether. Stress and addiction are closely tied together as many factors can be potential stressors and trigger episodes of substance abuse. The first step in managing both addiction and high levels of stress is often detox.

Medical detox may use medications to help control the side effects of drug or alcohol withdrawal, all while under constant supervision and medical monitoring. Mood-stabilizing medications may be useful in helping to control stress, anxiety, and depression during detox and potentially into treatment as well. Therapeutic and supportive methods that teach healthier ways for coping with and controlling stress are often included as part of a comprehensive treatment program following detox. Behavioral therapies can help individuals to recognize their potential triggers and learn how to manage them to prevent relapse. Support groups and counseling are beneficial in helping to set up healthy habits and sustain them on a long-term basis. Individuals who suffer from co-occurring mental health disorders, such as PTSD, benefit from integrated treatment models that work to manage both disorders simultaneously.

Tips for Managing Stress and a Substance Use Disorder

Addiction treatment programs are ideal in helping to manage stress and treat problematic substance abuse. There are also many things that an individual can do to help themselves during treatment and recovery to ease stress and strengthen against relapse.

Eat balanced meals. Proper nutrition can replace vitamins and minerals that may have been depleted through substance abuse. Foods high in protein and complex carbohydrates and low in refined sugars and saturated fats can promote brain health and healing.

Get enough rest. Sleep deprivation can increase stress levels. When the brain and body are rested, individuals can think more clearly, make better decisions, and better avoid relapse.

Avoid triggering events, people, or places. It is often best to stay away from things that are reminders trauma or substance abuse. For example, stay out of bars or away from people that enhance stress when possible.

Engage in creative activities. Finding a new hobby or healthy outlet to occupy the mind can enhance self-esteem and help to keep a person busy.

Practice mindfulness meditation and/or yoga. Mindfulness meditation techniques have been proven to reduce stress, as published in the journal JAMA Internal Medicine. The concept of mindfulness helps a person to become more self-aware and able to manage potential stressors by recognizing the body’s response and enhancing the mind, body, and spirit connection.

Reach out to others when needed. Don’t be afraid to ask for help when it is necessary. Talking to a therapist, counselor, family member, or friend is one of the best ways to relieve stress on a consistent basis.